Romatizmal mitral darlığı olan hastalarda uyku kalitesi ve perkütan mitral balon valvüloplastinin uyku kalitesine etkisi
Abstract
Giriş: Kalp hastalığı olan hastalarda uyku kalitesinin bozulması yaygındır. Ancak mitral darlık (MD) şiddetinin ve perkütan mitral balon valvüloplastinin uyku kalitesine etkisine ilişkin veriler sınırlıdır.
Gereç ve Yöntemler: Çalışmaya dahil edilen 205 hasta, ciddi ve ciddi olmayan (hafif-orta dereceli MD) romatizmal MD olarak iki gruba ayrıldı. Hafif-orta dereceli MD olan grupta 123 hasta ve ciddi MD olan grupta 82 hasta analiz edildi. Perkütan mitral balon valvüloplasti uygulanan ciddi romatizmal mitral darlığı olan 82 hasta prospektif olarak dahil edildi. Uyku kalitesi, perkütan mitral balon valvüloplasti işleminden hemen önce ve yaklaşık altı ay sonra prospektif olarak araştırıldı. Uyku kalitesini değerlendirmek için Pittsburgh Uyku Kalitesi İndeksi (PUKİ) kullanıldı.
Sonuç: PUKİ skoru ciddi MD olanlarda, ciddi MD olmayanlara göre oldukça yüksekti (sırasıyla 3,7 ± 2,0 vs. 7,7 ± 2,9; p<0,001). Toplam PSQI skorları ile ekokardiyografik parametreler arasında anlamlı bir korelasyon olduğu gösterildi [Sol atriyum çapı (r= 0,599; p=0,003), Mitral kapak alanı (r= 0,837, p<0,001), Transmitral ortalama gradyan (r=0,773; p<0,001) ), TR maksimum hız (r=0,593; p=0,004), Tahmini PAP (r=0,530; p=0,01), TAPSE (r=-0,510; p=0,013)]. Ayrıca ekokardiyografik parametreler ile toplam PUKİ puanları arasında yapılan çok değişkenli regresyon analizinde mitral kapak alanı (QR=0,73; 95% GA: 0,54-0,92; p=0,011) ve ortalama transmitral gradiyenti (QR=1,78; 95% GA: 1,44-2,18; p <0,001) istatistiksel olarak anlamlı bulundu.
PMBV işleminden 6 ay sonraki toplam PUKİ skorları, PMBV işlemi öncesine göre anlamlı derecede düşüktü (7,1 ± 2,7'ye karşı 3,9 ± 2,5; p < 0,001). Uyku kalitesinin subjektif bir ölçütü olan PUKİ skorunda bir iyileşme oldu.
Tartışma: Uyku kalitesini subjektif olarak değerlendirebilen PUKİ skoru ile mitral kapak darlığının şiddeti arasında belirgin korelasyon bulundu. Mitral darlığın şiddeti arttıkça uyku kalitesi bozulabilir. PMBV'nin ek bir faydası, altta yatan uyku bozukluğunu iyileştirebilmesi olabilir. Perkütan mitral balon valvüloplasti erişkin MD hastalarında uyku kalitesinin iyileştirilmesinde faydalı olabilir.
References
- 1. Desabandhu, Vinayakumar, Nithin Gopalan Peringadan, and Mangalath Narayanan Krishnan. "Safety and efficacy of percutaneous balloon mitral valvotomy in severe mitral stenosis with moderate mitral regurgitation–A prospective study." Indian Heart Journal 68.6 (2016): 783-787.
- 2. Rinkewicz, D., et al. "Natural history of moderate mitral valve stenosis." IMAJ-RAMAT GAN- 5.1 (2003): 15-18.
- 3. Carroll, John D., and Ted Feldman. "Percutaneous mitral balloon valvotomy and the new demographics of mitral stenosis." Jama 270.14 (1993): 1731-1736.
- 4. 2014 AHA ACC Guideline for the Management of Patients With Valvular Heart Disease, executive summary, a report of the American College of Cardiology American Heart Association Task Force on Practice Guidelines.
- 5. Sejbuk M, Mirończuk-Chodakowska I, Witkowska AM. Sleep Quality: A Narrative Review on Nutrition, Stimulants, and Physical Activity as Important Factors. Nutrients. 2022;14(9):1912. Published 2022 May 2. doi:10.3390/nu14091912
- 6. Irwin MR. Why sleep is important for health: a psychoneuroimmunology perspective. Annu Rev Psychol. 2015;66:143-172.
- 7. Tatyana Mollayeva, Pravheen Thurairajah, Kirsteen Burton, Shirin Mollayeva, Colin M. Shapiro, Angela Colantonio,The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis,Sleep Medicine Reviews,Volume 25,2016,Pages 52-73,ISSN 1087-0792.
- 8. Zhang, C., Zhang, H., Zhao, M., Li, Z., Cook, C. E., Buysse, D. J., ... & Yao, Y. (2020). Reliability, validity, and factor structure of Pittsburgh sleep quality index in community-based centenarians. Frontiers in psychiatry, 11, 573530.
- 9. Farah NM, Saw Yee T, Mohd Rasdi HF. Self-Reported Sleep Quality Using the Malay Version of the Pittsburgh Sleep Quality Index (PSQI-M) In Malaysian Adults. Int J Environ Res Public Health. 2019;16(23):4750. Published 2019 Nov 27.
- 10. Desai, Suneel Ramesh, and Nian Chih Hwang. "American Society of Echocardiography Recommendations for the Use of Echocardiography in Rheumatic Heart Disease." Journal of Cardiothoracic and Vascular Anesthesia 37.7 (2023): 1069-1071.
- 11. Hajj, J., Mathelier, H., Drachman, B., & Laudanski, K. (2020). Sleep Quality, Fatigue, and Quality of Life in Individuals With Heart Failure. The Journal for Nurse Practitioners. doi:10.1016/j.nurpra.2020.03.002.
- 12. Redeker NS, et al.. Characteristics of sleep in patients with stable heart failure versus a comparison group. Heart Lung. 2006;35(4):252–261
- 13. Lao, Xiang Qian, Xudong Liu, Han-Bing Deng, Ta-Chien Chan, Kin Fai Ho, Feng Wang, Roel Vermeulen et al. "Sleep quality, sleep duration, and the risk of coronary heart disease: a prospective cohort study with 60,586 adults." Journal of Clinical Sleep Medicine 14, no. 1 (2018): 109-117.
- 14. Lee, Kyoung Suk, Terry A. Lennie, Seongkum Heo, Eun Kyeung Song, and Debra K. Moser. "Prognostic importance of sleep quality in patients with heart failure." American Journal of Critical Care 25, no. 6 (2016): 516-525.
- 15. Coskun, Mükremin, Mevlut Koc, Abdullah Orhan Demirtas, Muhammed Zubeyir Aslan, Hilmi Erdem Sumbul, Hasan Koca, Tayfur Erdoğdu, and Yahya Kemal Icen. "Impaired self-reported sleep quality improves with radiofrequency catheter ablation in patients with premature ventricular complexes." Kardiologia Polska (Polish Heart Journal) 78, no. 9 (2020): 899-905
- 16. Kyoung Suk, Terry A. Lennie, Seongkum Heo, Eun Kyeung Song, and Debra K. Moser. "Prognostic importance of sleep quality in patients with heart failure." American Journal of Critical Care 25, no. 6 (2016): 516-525.
- 17. "Sleep quality, sleep duration, and the risk of coronary heart disease: a prospective cohort study with 60,586 adults." Journal of Clinical Sleep Medicine 14, no. 1 (2018): 109-117.
- 18. Eloi Marijon, M.D., Phalla Ou, M.D., David S. Celermajer, Ph.D., et al. Prevalence of Rheumatic Heart Disease Detected by Echocardiographic Screening. N Engl J Med 2007; 357:470-476 DOI: 10.1056/NEJMoa065085
Sleep Quality in patients with rheumatic mitral stenosis and the effect of percutaneous mitral balloon valvuloplasty on Sleep Quality
Abstract
Background: Impaired sleep quality is common in patients with heart disease. However, data on the effects of mitral stenosis severity and percutaneous mitral balloon valvuloplasty on sleep quality are scarce.
Materials and methods: 205 patients included in the study were divided into two groups as severe and non-severe (mild to moderate MS) rheumatic MS. 123 patients with mild to moderate MS and 82 patients with severe MS were analyzed. 82 patients with severe rheumatic MS who underwent percutaneous mitral balloon valvuloplasty were prospectively enrolled. Sleep quality was prospectively investigated immediately before and approximately six months after the percutaneous mitral balloon valvuloplasty procedure. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality.
Results: The PSQI score was considerably higher in patients with severe MS compared to mild to moderate MS (3.7 ± 2.0 vs. 7.7 ± 2.9, p<0.001, respectively). A significant correlation was demonstrated between total PSQI scores and echocardiographic parameters [ Left atrial diameter (r= 0.599, p=0.003), Mitral valve area (r= 0.837, p<0.001), Transmitral mean gradient (r=0.773, p<0.001), TR max velocity (r=0.593, p=0.004), Estimated PAP (r=0.530, p=0.01), TAPSE (r=-0.510, p=0.013)]. In addition, mitral valve area (QR=0.73; 95% CI: 0.54-0.92; p=0.011) and transmitral mean gradient (QR=1.78; 95% CI: 1.44-2.18; p <0.001) were found to be statistically significant in the multivariate regression analysis performed between echocardiographic parameters and total PSQI scores.
Total PSQI scores at 6 months after the PMBV procedure were significantly lower than before the PMBV procedure (7.1 ± 2.7 vs. 3.9 ± 2.5; p < 0.001). There was an improvement in the PSQI score, a subjective measure of sleep quality.
Conclusions: A correlation was found between the PSQI score, which can subjectively assess sleep quality, and the severity of mitral valve stenosis. Sleep quality may deteriorate as the severity of mitral stenosis increases. An additional benefit of PMBV may be that it can ameliorate the underlying sleep disorder. Percutaneous mitral balloon valvuloplasty may be beneficial in improving sleep quality in adult patients with MS.
Keywords
rheumatic mitral stenosis percutaneous mitral balloon valvuloplasty Pittsburgh Sleep Quality Index sleep quality
References
- 1. Desabandhu, Vinayakumar, Nithin Gopalan Peringadan, and Mangalath Narayanan Krishnan. "Safety and efficacy of percutaneous balloon mitral valvotomy in severe mitral stenosis with moderate mitral regurgitation–A prospective study." Indian Heart Journal 68.6 (2016): 783-787.
- 2. Rinkewicz, D., et al. "Natural history of moderate mitral valve stenosis." IMAJ-RAMAT GAN- 5.1 (2003): 15-18.
- 3. Carroll, John D., and Ted Feldman. "Percutaneous mitral balloon valvotomy and the new demographics of mitral stenosis." Jama 270.14 (1993): 1731-1736.
- 4. 2014 AHA ACC Guideline for the Management of Patients With Valvular Heart Disease, executive summary, a report of the American College of Cardiology American Heart Association Task Force on Practice Guidelines.
- 5. Sejbuk M, Mirończuk-Chodakowska I, Witkowska AM. Sleep Quality: A Narrative Review on Nutrition, Stimulants, and Physical Activity as Important Factors. Nutrients. 2022;14(9):1912. Published 2022 May 2. doi:10.3390/nu14091912
- 6. Irwin MR. Why sleep is important for health: a psychoneuroimmunology perspective. Annu Rev Psychol. 2015;66:143-172.
- 7. Tatyana Mollayeva, Pravheen Thurairajah, Kirsteen Burton, Shirin Mollayeva, Colin M. Shapiro, Angela Colantonio,The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis,Sleep Medicine Reviews,Volume 25,2016,Pages 52-73,ISSN 1087-0792.
- 8. Zhang, C., Zhang, H., Zhao, M., Li, Z., Cook, C. E., Buysse, D. J., ... & Yao, Y. (2020). Reliability, validity, and factor structure of Pittsburgh sleep quality index in community-based centenarians. Frontiers in psychiatry, 11, 573530.
- 9. Farah NM, Saw Yee T, Mohd Rasdi HF. Self-Reported Sleep Quality Using the Malay Version of the Pittsburgh Sleep Quality Index (PSQI-M) In Malaysian Adults. Int J Environ Res Public Health. 2019;16(23):4750. Published 2019 Nov 27.
- 10. Desai, Suneel Ramesh, and Nian Chih Hwang. "American Society of Echocardiography Recommendations for the Use of Echocardiography in Rheumatic Heart Disease." Journal of Cardiothoracic and Vascular Anesthesia 37.7 (2023): 1069-1071.
- 11. Hajj, J., Mathelier, H., Drachman, B., & Laudanski, K. (2020). Sleep Quality, Fatigue, and Quality of Life in Individuals With Heart Failure. The Journal for Nurse Practitioners. doi:10.1016/j.nurpra.2020.03.002.
- 12. Redeker NS, et al.. Characteristics of sleep in patients with stable heart failure versus a comparison group. Heart Lung. 2006;35(4):252–261
- 13. Lao, Xiang Qian, Xudong Liu, Han-Bing Deng, Ta-Chien Chan, Kin Fai Ho, Feng Wang, Roel Vermeulen et al. "Sleep quality, sleep duration, and the risk of coronary heart disease: a prospective cohort study with 60,586 adults." Journal of Clinical Sleep Medicine 14, no. 1 (2018): 109-117.
- 14. Lee, Kyoung Suk, Terry A. Lennie, Seongkum Heo, Eun Kyeung Song, and Debra K. Moser. "Prognostic importance of sleep quality in patients with heart failure." American Journal of Critical Care 25, no. 6 (2016): 516-525.
- 15. Coskun, Mükremin, Mevlut Koc, Abdullah Orhan Demirtas, Muhammed Zubeyir Aslan, Hilmi Erdem Sumbul, Hasan Koca, Tayfur Erdoğdu, and Yahya Kemal Icen. "Impaired self-reported sleep quality improves with radiofrequency catheter ablation in patients with premature ventricular complexes." Kardiologia Polska (Polish Heart Journal) 78, no. 9 (2020): 899-905
- 16. Kyoung Suk, Terry A. Lennie, Seongkum Heo, Eun Kyeung Song, and Debra K. Moser. "Prognostic importance of sleep quality in patients with heart failure." American Journal of Critical Care 25, no. 6 (2016): 516-525.
- 17. "Sleep quality, sleep duration, and the risk of coronary heart disease: a prospective cohort study with 60,586 adults." Journal of Clinical Sleep Medicine 14, no. 1 (2018): 109-117.
- 18. Eloi Marijon, M.D., Phalla Ou, M.D., David S. Celermajer, Ph.D., et al. Prevalence of Rheumatic Heart Disease Detected by Echocardiographic Screening. N Engl J Med 2007; 357:470-476 DOI: 10.1056/NEJMoa065085
Details
| Primary Language | English |
|---|---|
| Subjects | Cardiovascular Medicine and Haematology (Other) |
| Journal Section | Articles |
| Authors | |
| Publication Date | December 31, 2023 |
| Acceptance Date | October 4, 2023 |
| Published in Issue | Year 2023 Volume: 6 Issue: 3 |
